PROJECT SUMMARY/ABSTRACT Surefooted LLC is developing a novel type of physical therapy equipment with the potential to revolutionize fall prevention, the Surefooted Trainer (?Trainer?). 1 in 3 senior citizens experience a fall each year and falls are the leading cause of death by an injury among those aged 65 and older. Current treatments to prevent falls are inadequate. The Trainer consists of a 12 by 3-foot platform with interchangeable surface plates. The entire platform shifts abruptly to produce perturbations as a user walks back and forth on it whilst protected by an overhead harness. The Trainer aims to improve subjects? balance skills that are both anticipatory (using visual cues such as seeing an obstacle) and reactive (e.g. after experiencing a sudden perturbation). Dynamic gait training (i.e. user is walking) has been shown to be more effective than static balance training. The Surefooted Trainer will potentially increase subjects? resistance to falls for a long period after a single training session. The first specific aim is to improve the durability of the Trainer and automate the training protocol. The second aim is to determine the effectiveness of a 30-minute session on the Trainer during which subjects are exposed to 6 different conditions. The Surefooted Trainer is currently patent pending (US Utility and international PCT applications were filed in 2/2016). After demonstrating the Trainer?s effectiveness, Surefooted LLC plans to bring the device to the market and anticipates that it will become the standard of care in preventive health for people at risk of suffering falls.